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Vol. 29, Issue 9, 1216-1220, September 2001
Division of Clinical Pharmacology and Medical Toxicology, Uniformed
Services University of the Health Sciences, Bethesda, Maryland (S.A.C.,
D.B., D.R.F., L.R.C.); National Institute on Drug Abuse, National
Institutes of Health, Bethesda, Maryland (J.Z.M.); and Laboratory of
Clinical Pharmacology, Center for Drug Evaluation, United States Food
and Drug Administration, Rockville, Maryland (J.M.C.)
Vanoxerine
(1-[2-[bis(4-fluorophenyl)methoxy]ethyl]-4-(3-phenylpropyl)piperazine;
GBR12909) is a promising agent for the treatment of cocaine dependence.
Knowledge of the major pathway for GBR12909 metabolism is important for
prediction of the likelihood of drug-drug interactions, which may
affect the therapeutic clinical outcome, when this agent is used in
cocaine-dependent individuals receiving multiple drug therapy. We
studied biotransformation of GBR12909 in human liver microsomes
(n = 4), human hepatocytes, and microsomes containing cDNA-expressed human P450 isoforms with GBR12909
concentrations within the range of steady-state plasma concentrations
detected in healthy volunteers. A high-pressure liquid
chromatography assay was used to measure parent GBR12909 and its
primary metabolite. GBR12909 was metabolized by human liver microsomes,
hepatocytes, and cDNA-expressed human P450s to a single metabolite.
Ketoconazole, a selective inhibitor of CYP3A, reduced GBR12909
biotransformation in human liver microsomes and primary hepatocytes by
92 ± 2 and 92.4 ± 0.4%, respectively. Quercetin (an
inhibitor of CYP2C8/3A4) was a less effective inhibitor producing
62 ± 22% inhibition in human liver microsomes and 54 ± 35% in hepatocytes. Other P450 selective inhibitors did not decrease
GBR12909 biotransformation more than 29% in either human liver
microsomes or hepatocytes with the exception of chlorzoxazone (CYP2E1),
which inhibited GBR12909 biotransformation by 71.4 ± 18.5% in
primary human hepatocytes. Ciprofloxacin (CYP1A2), sulfaphenazole
(CYP2C9), quinidine (CYP2D6), chlorzoxazone (CYP2E1), and mephenytoin
(CYP2C19) did not demonstrate statistically significant inhibition
(p > 0.05) of GBR12909 biotransformation in
liver microsomes. cDNA-expressed P450 3A4 metabolized GBR12909 to a
greater extent than 2C8 and 2E1. These data suggest the possibility that multiple P450 isoforms may be involved in human GBR12909 metabolism but that CYP3A appears to be the major enzyme responsible for human GBR12909 biotransformation.